John Kasich signed a budget bill a week ago that did not include a proposal for Medicaid expansion. Regardless, the issue remains a live wire.
The governor vetoed language in the bill that blocked expansion of the health program for low-income families. And justly so; there is a great deal at stake. It involves a federal offer that represents billions of dollars for health care in Ohio. It relates to how state lawmakers structure health policy to accommodate tens of thousands of residents who lack health coverage in a system undergoing swift transition. The controversy also illuminates the push-and-pull between the demands of public policy and partisan ideology.
Advocates for expansion are backed by broad public support. Rightly, they are keeping up the pressure, holding out the possibility of a petition drive to put the issue on the November ballot and planning another Statehouse rally on Tuesday. It is encouraging that the budget legislation is not the last word on Medicaid expansion. In the House and Senate, Republican leaders have signaled bipartisan panels will continue to work through the summer on an overhaul of the health program. Speaker William Batchelder thinks the House may have a bill ready by Labor Day or soon thereafter, while Senate sponsors of a reform bill introduced last month expect a revised version later this month.
It is disappointing that the Medicaid option (which studies show would cover about 275,000 uninsured Ohioans, most of them low-wage workers) remains unsettled. Disappointing, too, is that despite talk about a bipartisan legislation, a gulf of difference remains unresolved. A staunch opponent of expansion, Batchelder points out, for example, that while the governor is talking expansion, the House isn’t, notwithstanding solid studies that have listed the multiple benefits to Ohio.
Also, the demand to overhaul Ohio Medicaid as a first priority has all the appearance of a red herring, a distraction from the consequences of denying health coverage to more than a quarter-million constituents. During the past two years — longer in some cases — the program has undergone substantive changes to improve the quality of services, reduce overspending, waste and fraud and tighten oversight. A recommendation to make Medicaid a stand-alone department, first made in 2005, finally is being accomplished.
The reasons are compelling to cover uninsured Ohioans who earn no more than $15,856 a year. As public policy, it would offer a healthier work force, the bulk of the cost paid with federal dollars, a plus for the state economy. It will be Ohio’s gain if lawmakers seize the window of opportunity in the next few weeks to craft a Medicaid expansion.